Monday, June 04, 2007

The world's a more disturbing place...

I'm getting more scared by some of the young patients I'm seeing, who at 10 years old are like 88 kilos. Young girls. That's like 20 kilos more than I weigh. What the hell? I wonder what it's going to take to make kids (and their parents) change. It's sort of analogous the increasing interest in hybrid cars. It took petrol prices to shoot through the roof before people started considering them. Yeah, environmental concern was part of it...but not the primary concern. What's going to make measures to be put in place in schools/families to decrease the chances of being squashed by someone decades younger than you?

And, I had a patient the other day who required me to write on her school note that she was allowed to drink a bottle of water at school. I was like...what?! Apparently, the school won't let any of them carry bottled water because they're afraid kids will bring and drink alcohol in school! That's nuts! I mean, I'm sure they could...but wouldn't it be obvious picking out the complete smashed kid? and smell it? And wouldn't it be really dangerous for kids not to have adequate hydration? Man, things have really changed from when I was in high school...and that wasn't that long ago!

Finally! I'm nearly done!! (with med school)

The last time I posted, I'd just finished Step 2 CK. It didn't go as well as I wanted, but passed anyway. So that's my ECFMG certification stuff done. I'm not that happy with how I've done academically during med school, but considering all the stuff I've been able to do apart from medicine, I'm fairly happy with the life experiences I've gotten from studying abroad in Ireland. I'll go more into specific pros and cons later.

The exams were nerve-wracking as we expected. The medicine and surgery papers were fair (except the surgery MCQ was a bit all over the place and definitely not very well organized). The day between the med and surg papers, I found out about a job opening in the US and given the uncertainty of getting a job in Ireland this year, I spent the whole day getting ready and faxing application materials, so didn't start cramming surg until 6 pm ! Definitely not good preparation, but I figured I had to take a shot at this opening, even if it was a long shot.

Then the day after the surgery paper, I was cycling a friend's racer to meet a couple friends for lunch near the hospital. My front wheel clipped and got stuck in the tram tracks, and I went flying. Must have landed under an out-stretched shoulder cuz I dislocated my left shoulder. Being in front of the hospital, I walked to the Emergency Department and was seen fairly quickly (it was quiet). It hurt like hell...I knew dislocated shoulders were supposed to be really painful, but I was really surprised at how much it actually did hurt (when the meds wore off). So then I had to be in a sling for the next 3 weeks - didn't take pain meds cuz they made me really sleepy, and then the diclofenac they prescribed made me quite ill, so stopped taking that. My friends took care of me that weekend though ;). Healing is really slow...nearly 6 weeks on, and I still can't extend my arm to its full range of movement. Abduction's back though!

The following Monday I had a psych paper, which was ok... I wish I'd done more studying for it because I could have done quite well on it. Studying was basically non-existant because the pain meds knocked me out or I was sick from meds. I learned my lesson! Then had a week off before the clinicals. The orals were strange given I only had one arm and couldn't do some of the physical exams....so I got asked some very weird questions instead. Can't say I'm the most loquacious... I wasn't really happy with the long cases, but the shorts in medicine went well. Managed to get through them fairly un-traumatically, one hand and all, and then had an agonizing wait to see if we got Dublin internships or not. After the school playing us around a bit, the postings finally came out 5 days late and fortunately I got a job! Unfortunately, 16 of my class didn't...I hope they've all found suitable alternatives that they're happy with. This whole situation is absolutely ridiculous.

Went straight from finding out about job postings to Kerry to spend with two of my best friends (both rowers, both in medicine) and it was absolutely beautiful. 3 days of doing nothing except enjoy the gorgeous sun on the beach. Anna took us to places she grew up with during childhood, with some stunning spots that have and will remain untouched. Some of the area is very mountainous so can't really be habitable, and the water lying between the mountains is therefore pure. The views were amazing and it made me fall in love with Ireland again (the past couple years have seriously tried my enthusiasm for the place). But I think it's back :).

Then the 2nd week of May was a hectic one, spent searching apartments in the Islandbridge area for something suitable. As all my classmates were away on holiday and I wasn't really keen on sharing (8-9 years in dorms is quite enough, thank you!), landed myself a sweet little place right next to the boathouse (my 2nd home!) in a lovely complex. Quiet, young area and professional area, with a little fountain and garden...expensive but worth it. Especially after some of the infested ones I visited during my search!

That weekend, I was off to London - sent by the IARU (rowing union) to attend a FISA classification workshop for adaptive (disabled) rowers and it was really useful. Once my documentation's turned in, I'll be the first and only medical and technical rowing classifier in Ireland for awhile, until they send more to be classified. Basically, I'll be officially classifying the athletes into boat categories to optimize their rowing abilities. It's a great project to be involved with helping the IARU to set up a Paralympic team, now that rowing is part of the Paralympic games. And from a medical point of view, the neurological conditions the athletes present with can be very interesting...complete or partial transections, amputations, polio, etc.

A few days later, I was back home to do an elective in Pediatric Emergency Medicine in the Cincinnati Children's Hospital. After a flight back from hell (I had to spend a night on the airport floor and it was Newark, for god's sake) I had a couple days to become unjetlagged and catch up on movies. I've completed 2 weeks of the elective and now have my last 4 days (yay!). To be honest, I haven't enjoyed this rotation as much as my November one at CCF - I liked CCF's structure a bit better, as it can be over-staffed and over-structured here. Also, I think I'm more of a fan of adult medicine versus pediatric medicine. I've found it hard to get to know the attendings because there's not as much contact with them as I had at CCF, so trying to ask for a letter might be awkward. And this whole precepting to fellows who then precept to the attending thing gets kind of annoying. Plus, there's no computer charting at our level anyway, which I don't really like. On the flip side, the kids can be really cute! This elective hasn't deterred my interest in EM any, and overall it's a good experience - I've rediscovered my weak points and have learned not to make assumptions (even though my assumptions are usually right. Better to be completely thorough!). I just feeling "meh" about this rotation has partly to do with me being at the end of my med ed tether and just wanting a break for awhile.

I go back on Friday, and when I land I go straight to Belfast to try to catch my gals' race (Lomac Tiles against Queens University is always very fun!), back down to a 21st, and then to Castleconnell for an adaptive rowing meeting the next day. A couple days to fix up my apartment and set up utilities, then mom's coming for graduation (June 15th, yay!). Busy busy busy! I'll be with my friends again! YAYAY!

The future...mall walking?

I just wanted to say that I had no idea mall walking was that big in this country. I mean, I knew people did it...mainly old folks who were told by their docs to get some exercise...but I went to the mall early today trying to beat the rush and ended up having to wait around til they opened at noon. I must have been the only person there not walking...I was lapped by at least 150 walkers in the span of 45 minutes. On one hand I feel it's a bit sad...what happened to walks outside and enjoying the fresh air? But on the other hand, at least they're getting some exercise...and can spend some money afterwords. If I mall walked, I'd reward myself with at least some iTunes afterwords.

Monday, March 26, 2007

Ho hum

2 more weeks til my last exams start, and 5 more weeks of study until I'm done with my formal medical education. On Friday, I had my last lecture of 24 years of schooling. You would think we'd be a bit nostalgic about it, but no...all of us are just ready to get out. Our class has seen some rough times and it's only going to get rougher with this politics nonsense regarding jobs. I hope to god I get an intern job...otherwise I will be very very depressed and basically have no clue what to do.

Anyway, what's happened since the last blog... I took Step 2 CK, and while I didn't think I did brilliantly, I thought it was ok. I was a little unhappy that I wasn't completely confident in flying it, but c'est la vie...that rarely happens with these kinds of 8 hour exams. I could always narrow it down to 2 answers and then was trying to choose between them. Hopefully I chose right! Not as difficult as Step 1, but given limited time to study for it, think I may have been able to do better. A few of my classmates are taking it in May, and that gives them more time...but I'm happy to have it out of the way and not doing them after finals. I honestly don't think at this point in time that I would do better now than I would have 4 weeks ago.

A big plus for me was that my girls won their novice colours race :). That was brilliant, and they stuck to the race plan exactly, and they rowed better than I thought they would. That was fantastic. And nice validation for myself and Anthony that we are doing something right in the coaching area, as the coach we were up against has been coaching for awhile. Everyone had a good night out but I wasn't drinking and left early. Ironically, I was hammered later in the week when we had Commons dinner for final meds. The malaysians weren't drinking so we took all their guinnesses and wine, then went to the Pav and Gingerman afterwards...all of us were fairly smashed after like 2 pints. hhehe.

So two weeks til the finals. They always say things will come together and consolidate. Maybe it's happening a little...but I'm still waiting to feel solidified!

Monday, February 12, 2007

2 more weeks til Step 2 CK! AAAAAAAGH! At least it's slightly easier than Step 1, but still...AAAAAAGH!! I think I've planned my study a bit better than Step 1 though, so that's good. but there's always something to not know. I'm pretty much skipping the next 2 weeks of hospital to study for this exam, and a bit worried that that's going to bite me in the butt. I'll just have to work really hard to make up what I've missed and go see some patients! But I really want to nail step 2 cuz I recently received a couple fantastic recommendation letters from attendings at my last rotation which should carry me a good way during interviews as they come from a prominent hospital. That's always a confidence booster ;). But now I need the rest of my application to be solid, as I already have a blip in it from step 1. Sometimes I think I should have waited til May to take Step 2, but seriously...I do not want to take another exam after my finals!

Other than that, have mainly just been coaching. I'm really annoyed at the fact that I'm missing all the rowing parties (yargh!) but just have to have a willpower of steel to get through the end of med school. The girls have had a couple of races and I think they're starting to understand how to move together. If we can just find a way to solidify it (and quickly), regatta season should be a blast !

There've been a couple med parties - one was after the end of the biosoc inaugural and I stayed later than I should have, but it was a lot of fun. One of my Irish friends was really cute and telling me how much she'd miss me and kept hugging & kissing my cheeks. We were really starting to look gay, but ah well. And for med ball ...that was just messy. Another of my friends was hammered, puked on the carpet and left quite early cuz he was so drunk. I called him the next day and he wasn't hungover one bit, the bastard!

Anyway, speaking of drink, I want one. So I better stop before the temptation becomes too great and I end up drinking by myself at 4 pm.

Monday, January 15, 2007

The end's in sight :)

So one of my mates found this site which reminded me I should update it :). So let's see...after the last blog, that was two months of hell studying for the paediatrics and obstetrics/gynecology exams. The written exams were ok but the orals are so subjective, it's really luck of the draw as to what case you get assigned and they're hell! But it all worked out ok.

After the exams, I went back to the Cleveland Clinic to do an elective in ER. It was awesome, maybe not as much fun as MICU in the summer because it's more individual and less team-based, but I loved it. For the last while I've been considering ER for my career and this elective just confirmed it, and of course the great staff made it more appealing. Just my personality seems to fit in - active, hate waiting around, want stuff done with some intensity but like having fun too. Anyway, I think I performed well during the elective and I enjoyed being there so hopefully will get an elective in a Level I trauma center for May after my last set of exams.

I came back to Dublin for Christmas and had a very lovely Irish Christmas as my friend's house (I love real fires. I don't care how much work it takes to clean a chimney, I'm definitely having a real fireplace when I grow up). And probably ate a whole hog in ham :)! It wasn't just all lazing around though, went sculling with friends on Christmas and Stephen's Day - water was lovely, would have been a shame to miss it. I do miss not being able to do as much rowing this year, but am definitely enjoying coaching novices. They're such a fantastic enthusiastic bunch, they make me smile :).

Then for New Years, myself and 2 other friends (from rowing) went to Oslo for 5 days in Norway to visit one of our Norwegian friends. That was really really nice. Her house is really cozy and modern, and it was fantastic getting to catch up with her again since she's really busy at her new job and all of us are busy with life in general. Didn't get to go skiing, but went ice skating instead, and visited a proper ski jump place so we could see what it was like looking down. Only it was very foggy, but you got the idea anyway. Visited her boathouse and stood on some frozen water, walked around Oslo city (it's lovely! big streets, clean). For New Years, we got dressed up and had a fantastic dinner (for 22 at hers), got quite drunk of course and toasted the New Year at a hotel. It might have been the drink or my lack of contacts but when we got home and into our comfy pj's I nearly got into a fight with a guy I thought was a burgler (we still aren't quite sure how he got into the house), but fortunately it didn't come to that. Haven't gotten that agro in awhile!

Now back and straight into hospital work for the last 3 months before our finals in Medicine and Surgery. It's been really tough. Sometimes in from 7:30 (meaning catching the tram at 6:30) and sometimes not done til 7, with no lunch break. Everyone's now stressing cuz we have no time to study and they keep telling us they want us to see patients and we're like...when exactly do we have time for that? And I have to take USMLE 2 Ck at the end of Feb so I'm being antisocial and studying / doing questions in any spare moment I have (now doesn't count). made more difficult by coaching (which I'm not giving up) so I don't get home til really late sometimes. Anyway, where there's a will there's a way! So hopefully everything will work out. There's still so much I need to refine and revise!